Medical History Update

June 13th, 2015 - By steve.mccormack

Medical History Update:

 Why Is This Needed?

 

Most Patients might not realize the importance of a current medical history with their health professional. 

The safe and successful completion of dental care is often times significantly influenced by a patient’s health and medications.

Let me give some examples of why it is important to keep an accurate medical history of our patients so that we “don’t treat a stranger!”

 

  • Many medications cause dry mouth [xerostomia] … and that leads to a high risk for gum disease and cavities.
  • Many medications … and herbal supplements … influence bleeding and clotting times.
  • Anesthetics like “Novocain” interact or are influenced by the medications a patient takes.
  • Medications can cause patients to faint more easily in the dental chair when we change the position of the chair, or stand up too quickly, or are stressed by their dental care.
  • Past medical surgeries, general anesthesia, surgical complications, medicine interactions or problems, and more can influence our treatment recommendations.
  • Diabetes, heart disease, and smoking have a significant impact with your dental care.
  • Referrals to specialists … like oral surgeons and periodontists … dictate that we know our patients and refer patients appropriately.
  • Liability issues can arise if we are not made aware of medical issues that would influence any dental treatment.

 

Please know that we will keep your information confidential and use it appropriately to recommend dental treatment.  Your trust is important to us, but we do want to be fully aware of any health issues and medications before providing you with care that is in your best interest.

 

Steve McCormack, DDS

 

 

3RD Molars / Wisdom Teeth

May 1st, 2015 - By steve.mccormack

 

3rd molars [wisdom teeth] usually develop and erupt around age 18.    It is at this time that a special X-Ray is often times taken … called a panoramic x-ray.     At our office then we decide if the 3rd molars should be extracted.

Typical reasons for removing 3rd molars are:

  • There is not enough room for full eruption into the correct position.
  • They are impinging on the neighboring molars.
  • They may increase the odds of further crowding of your other teeth.
  • They develop very sore or infected gums if they are only partially through the gum … and cannot fully erupt into position.
  • If they are partly erupted they are very hard to clean and much more prone to decay and gum disease.
  • Without the 3rd molars it is easier to clean the 2nd molars in front of them … further reducing the risks of cavities and gum disease on these teeth.
  • Unerupted 3rd molars sometimes develop cysts around them, which requires their removal.

At a young age the wisdom teeth are easier to remove, since often times the roots have not fully formed.  Also, teenagers heal more easily and thoroughly than older adults.

Note the 4 wisdom teeth … all impacted under the gum and jaw bone.

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Note all four 3rd molars …  2 are erupted almost completely and 2 are impacted completely.  Also, the one on the lower left side of the x ray has a cyst around it.

Cold Sores? Canker Sores?

April 16th, 2015 - By steve.mccormack

Cold Sores or Canker Sores Got You Down?

  1. We can  prescribe an anti-viral medicine that takes only 2 doses and is very effective with COLD SORES  if caught at the first earliest stage.
  2. We have a way to stop CANKER SORES in 30 seconds too.      Virtually instant pain relief!

Of Course … We need to see you to verify what is the source of your pain and blisters.

We have to rule out infections, oral cancers, trauma, etc.     

Let us help you get pain relief from these annoying blisters and ulcers.

 

 

 

 

Bad Breath?

March 30th, 2015 - By steve.mccormack

Have a look at this Oxyfresh or CloSYS web site.  The Products section is helpful.

The active ingredient is Chlorine Dioxide … and it Works!

Obviously there can be several causes of bad breath, but the “volatile sulfur compounds” that accumulate on the tongue are the number one culprit.  Click on a link below.

Oxyfresh Link

https://www.closys.com/our_products/?gclid=CObTo_KYwtMCFQUMaQodRFoAvA

This is what clean teeth  REALLY  look like!

 

25 Years In 2015

March 1st, 2015 - By steve.mccormack

McCormack Dental Office

Celebrating 25 Years in St Croix Falls

IMG_4340As of 2015  I have had my dental office in St Croix Falls for 25 years !

To celebrate that milestone I decided to spearhead a campaign to get donors for these bike racks in town.  28 racks were donated at $300 apiece.

I kicked off the campaign and donated 6 racks myself.  [Better than a pig roast for my patients I thought.]

It is an effort I have undertaken to develop our city theme, “City of Trails.”   Our 4 trail types are Snow … Foot … Bike … and Water.

 

Artificial Joints and Antibiotics

January 23rd, 2015 - By steve.mccormack

Do you have an artificial knee or hip joint?  

Have you been taking antibiotics before all dental appointments?

You may not have to take those antibiotics anymore.

joint

An American Dental Association panel of experts, in conjunction with the published recommendations from the American Academy of Orthopedic Surgeons from  2012 has made this clinical recommendation…

“In general, for patients with prosthetic joint implants, prophylactic antibiotics are NOT recommended prior to dental procedures to prevent prosthetic joint infection.”  Probably 90% or more of patients will NOT need antibiotics now.

Reasons to continue taking these antibiotics before your appointment are:

  • if you are immuno-compromised
  • if you have had joint infections or complications
  • if you have ever taken osteoporosis medicines
  • if you have been on long term steroids like prednisone

HOWEVER …. the local orthopedic group of surgeons … St Croix Orthopedics … has chosen to continue to tell ALL patients to continue with antibiotics before all dental appointments.   This conflict in recommendations will confuse patients, so I would suggest you have a serious discussion with your surgeon at your next visit.

Ask them”why do I have to take antibiotics …. it is not what is currently recommended?”

Dr. McCormack will follow the recommendations of the American Dental Association and the American Academy of Orthopedic Surgeons … and discuss with each individual patient whether they should take antibiotics or not for their dental care.

[2] The Importance of Fluoride

December 15th, 2014 - By admin

fluoridated water

 

The American Dental Association position on Community Water Fluoridation

• All water, including lakes, rivers and the ocean, contains naturally occurring amounts of fluoride.   If the natural level of fluoride in water is very low, public water systems may adjust it to an optimal level proven to help prevent tooth decay–approximately 1 part of fluoride dissolved in a million parts of water. This process is called community water fluoridation.
• Based on the weight of scientific evidence, which indicates that community water fluoridation can help prevent up to 40 percent of tooth decay, the American Dental Association remains a strong advocate for community water fluoridation.    The World Health Organization, the American Medical Association, the Centers for Disease Control and Prevention as well as the ADA and many other health organizations acknowledge that water fluoridation is a public health measure that has contributed to a significant decline in dental decay over the past 70 years.

Over the Counter Whitening Products

May 10th, 2014 - By steve.mccormack

What about OTC whitnening products like strips, toothpastes, rinses, etc?

There are various products made by Crest and Rembrandt that are safe and effective.  However, they are not for everyone.      Also, their effectiveness and usefulness are limited.

  • Whitestrips   …   these are small strips [think cellophane tape] that fit over the front teeth and have a gel on the inside.  This gel has a similar active ingredient as the office gels we supply as part of our home whitening system.  These are sold in retail stores and are OK to use for some … not for others.   Name brands like Crest or Rembrandt are reputable manufacturers.
  • Whitestrips … Who should use them?   First of all, note that all bleaching products only work on natural teeth, not fillings or crowns.   I have not seen consistent success with adults.    For ages 18-30 it can be very effective for many.     For most adults the office supplied, customized products we use can get very good results and with fewer side effects.
  • Rinses and toothpastes   …  Most of these have minimal effectiveness for “whitening.”    They primarily help to eliminate or reduce surface staining.     Also, some people develop sensitivity with their teeth with regular use.  Bottom line   …   pick a toothpaste that tastes good and has fluoride.    They are all so similar as to make them essentially equal.
  • In-Office [one appointment] bleaching… This is a system that uses very concentrated products to get your whitening done in a single appointment.      I am not an advocate of this because it is expensive, labor intensive, can cause more tooth sensitivity, and usually doesn’t end up with any better result than our home whitening system.
  • Custom made Home bleaching traysThis is our preferred method.  It allows flexibility for length of time used and allows flexibility on the most appropriate products.     Also, if you keep your tray you can touch up once a year and simply buy another tube or two of the bleaching gel.   We supervise its use and can usually get very nice results.
  • Ready-made Opalescence trays.  These are one-size-fits-all trays [supplied by our office] that apply a whitening strip to your teeth.  This strip stays on for 30-60 minutes since it is a high strength whitening agent.  I like this for younger people since it is very effective for them.  It is not as good for patients with tougher stains that require longer use and custom trays.

This information  supplied by  Dr. McCormack

Kids Teeth & Decay … Baby Teeth Matter!

January 31st, 2014 - By steve.mccormack

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Kid’s Teeth ARE Important  

[click this video link from the WDA]

 

Baby teeth should be kept healthy until the adult teeth erupt.  Some baby teeth aren’t lost until age 11 or later.

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  1. They hold position for the permanent teeth.    Early loss means extra crowding in the adult teeth.
  2. Baby teeth can decay, become abscessed, chip or break like adult teeth.   Keep them healthy!  They are important.
  3. Children should be seen by age 1 or so for a first visit examination.    Don’t wait until age 3 or 4!
  4. Most children who start seeing us by age 1 are doing very well in the chair [by themselves] by age 2-3.

Why Don’t Dentists Take Medical Assistance?

October 31st, 2013 - By steve.mccormack

ForwardHealth--smLogo

… An important question we are asked a lot.

As you might already know, it’s because the medical assistance program is broken like so much of our health care system.

For starters, MA reimburses at about 35% of dentist’s fees.   In our case our fees are, on average, 25-50% less than dentists in the MPLS-St Paul area so you can see how bad the reimbursement rate is. Unfortunately though, every hospital, nursing home, pharmacist and more are crying over the poor rates too. But it’s not just about the money.

Paperwork can be a bear, too. There are restrictions, pre-approvals and more that un-necessarily complicate things. Things have improved significantly with electronic records and on-line capabilities though.

Unfortunately too, is the reality that MA patients, when they are able to find a dentist taking MA, fail their appointments more than most.

So, the “government” decided one fix was to create FHQC … federal health qualified centers. These are brand new larger clinics with dentists who see MA patients and non-MA patients alike. The goal was to get care to the MA patients … a noble one … but in my view a poor one. These all new clinics are built with mostly federal funds, get much higher cost based reimbursement rates, offer loan forgiveness to new dentists, and receive operating grants.

For Polk County residents, the closest ones are in Rice Lake and Chippewa Falls. Even worse is that they have stated they will no longer take Polk County residents! I thought these were federally funded clinics in part? So MA patients with toothaches go to the emergency room at the local hospital and simply receive antibiotics and pain pills, which do very little to help. It’s expensive government reimbursed care that could be better used elsewhere.

The thinking has always been that if the reimbursement rates were a little better, most dentists would accept MA and none of the FHQC would have had to have been built … and maybe emergency room visits would go down.

So what does our office do to help? We do not accept MA patients for comprehensive care. However we do see some emergency only patients, especially children. We also donate care in some cases.

Of note too … Since we are an MA provider we are obligated by the MA program not to accept private pay for dental care. That means that even if an MA patient wants to pay for it all themselves, we cannot accept that. A non-MA provider can take private money. We have to bill MA for anything we do and accept that as final and total payment.

It’s all so frustrating. The MA system is a poor one, and too many dentists regrettably won’t even offer occasional emergency care. I wish it were better.

MA graph